- Allowed in-network charges for fixed-wing air ambulances rose 76% between 2017 and 2020, and now top $15,000, a new study by Fair Health found. The average charge rose 27.6% during the same time period, to more than $24,500 from little more than $19,200. For helicopter transports, the average allowed charge rose 60.8%, from just over $11,600 to more than $18,600.
- Meanwhile, the average Medicare reimbursement rose much less dramatically between 2017 and last year, and represents just a fraction of what commercial insurers are charged for air ambulance transports.
- Demand may be part of the equation. Fair concluded that air ambulance claims rose 30% between 2016 and 2020. The leading reasons for such transports are digestive issues, heart attacks and bone breaks or fractures. The states with the largest volumes of fixed-wing air transports are rural: Alaska, Wyoming, South Dakota, Montana and New Mexico. For helicopters, it's Idaho, South Dakota, New Mexico, West Virginia and Wyoming.
The air ambulance industry has received significant scrutiny from both state and federal regulators in recent years, as mostly rural patients suffering significant health issues or injuries from accidents were often facing down huge bills that their insurers often would not pay. More than 70% of ambulance rides — both air and ground — subjected those with health insurance to a surprise bill. Such practices will soon be banned under a federal law set to go into effect Jan. 1.
However, the new study from Fair Health indicates that even among insurers, charges have been dramatically ratcheted up in recent years.
The average in-network allowable charge paid by insurers for fixed-wing transports reached $15,624 last year, up from $8,855 in 2017.
Most patients requiring air transport are over the age of 65. That cohort accounted for 55.4% of claims for fixed-wing transports and 63.6% of claims for helicopter transports.
That means Medicare pays the most air ambulance claims, and that program appears to have kept a lid on rising costs. The average Medicare reimbursement for a fixed-wing transport was just $3,216 last year. That was up just 4.7% from 2017, when it was $3,071. Medicare also kept tight controls over reimbursements for helicopter transports. Its average reimbursement was $3,739 last year, also up 4.7% from 2017, when it was $3,570.